Incurable Anemia
Treating anemia, treating it… and no result. Sounds familiar? Let’s sort it out 👩💻
The most common types of anemia are deficiency anemias. They develop due to insufficient intake or increased consumption of:
- ✅ Iron and/or
- ✅ Vitamin B12 and/or
- ✅ Folic acid (Vitamin B9).
Why supplementation doesn’t always work
This is why, when anemia is detected, iron is often prescribed immediately, and sometimes B12 and folic acid “just in case.” 🤬
But if the anemia is not caused by a deficiency of any of these (something that can easily be determined in any lab by checking blood levels of iron, B12, or folate), then supplementation will not help. 😥
👉 Tests must be done before treatment starts. Even a single iron pill or one B12 injection can normalize the blood results and prevent identifying the true cause of the anemia.
Other causes of “incurable” anemia
🙈 In some cases, anemia may truly be incurable or very difficult to treat, especially if it is related to impaired blood formation in the bone marrow — the critical organ where all blood cells, including hemoglobin-containing red cells, are produced.
❗ A drop in hemoglobin is what we call anemia.
When the process of blood formation itself is disrupted, possible causes include:
- ✔️ Acquired aplastic anemia (blood cells destroyed by the immune system) or hereditary forms
- ✔️ Myelodysplastic syndrome (clonal blood cells that function abnormally and may also be destroyed by the immune system)
- ✔️ Leukemias and lymphomas with bone marrow involvement
- ✔️ Cancer metastases to the bone marrow
- ✔️ Consequences of chemotherapy or marrow-toxic drugs
- ✔️ Many other rare conditions
✅ Another situation where anemia is hard — or sometimes impossible — to treat: increased destruction of red blood cells (hemolysis).
A very rare cause: IRIDA
🙊 Finally, another additional — though extremely rare — cause with a beautiful name: IRIDA (Iron-refractory iron deficiency anemia).
We deliberately didn’t start with it 🙊 — this is an exceptionally rare disease and should never be the first thing to suspect if iron therapy is ineffective. There are at least five much more common reasons for iron therapy failure 😁.
IRIDA is a hereditary disease caused by TMPRSS6 gene mutation, which impairs absorption and utilization of iron. Oral iron is ineffective despite profound deficiency, while intravenous iron produces only a “blunted” response.
Key note 💡
Treatment failure with oral iron due to too low a dose, too short a course, or patient non-compliance is far more common than IRIDA or other genetic syndromes causing resistance to iron therapy.
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